Predictors of Initial Acceptance of Continuous Positive Airway Pressure in Obstructive Sleep Apnea Patients After Intensive Educational-Behavioral Program

Background: Continuous positive airway pressure (CPAP) device therapy is the standard treatment for obstructive sleep apnea (OSA) to date. However, acceptance and adherence rate remained low. Recent study showed that educational and behavioral modification program can improve the efficacy of CPAP use. Objectives: To study rate of acceptance and its predictor factors of in patients with obstructive sleep apnea after participant in group modification behavior program. Methods: This prospective cohort study was conducted in 247 obstructive sleep apnea patients at Ramathibodi Sleep Disorders Center, Ramathibodi Hospital from February to July 2015. There were indicated for CPAP. Participating states spanning included awareness, motivating, demonstration, and trials of CPAP evaluated every week for 3 weeks. Results: Of 247 obstructive sleep apnea patients (62% male) were included with apnea-hypopnea index (AIH) (median [interquartile range], 41.5 [46.4]), and acceptance CPAP (85%). Factors influencing decision to use CPAP were severity of diseases (OR, 4.1; 95% CI, 1.2 - 13.9), triple trials (OR, 8.6; 95% CI, 2.1 - 35.4), and government reimbursement (OR, 8.1; 95% CI, 2.9 - 22.4). Conclusions: After educational and behavioral intervention, the CPAP acceptance rate were high among Thai patients with obstructive sleep apnea. This program should be encouraged for more widespread clinical practice.